Summary box

• Epidemic disease outbreaks are typically regarded as newsworthy events monitored by national and international media. Traditionally, governments are primarily responsible for outbreak response and communication to the press as well as stakeholders. But in our experience, governments, especially in West Africa (including Nigeria), are sometimes unwilling to rapidly report outbreaks or under-report the scale of the outbreaks.

• We identified reasons that could explain this unfortunate practice: weak health system capacity and fear of international isolation/stigmatisation; poor prioritisation of health and health emergencies in the context of economic downturn; weak leadership and accountability and knowledge deficit on outbreaks and management approach.

• Based on our experience in Nigeria, we propose that public health authorities, with the support of WHO and UNICEF of country offices, should strengthen engagement with political office holders and orientate them on the importance of reporting outbreaks and timely response, advocate for better funding (for clinical and laboratory surveillance as well as response) and address corruption by instituting and enforcing monitoring and accountability for public health officers.

• The polio legacy plan in Nigeria should be targeted at strengthening Integrated Disease Surveillance and Response (IDSR). The robust personnel strength, capacity built, network of laboratories as well as the evolving collaboration between conventional (formal) and alternative (informal) reporting system should be optimised and diversified to effectively detect, report, respond to and monitor disease outbreaks and other health emergencies.